Employers Compliance with the Health Insurance Act ANNUAL REPORT. Bermuda. Health Council

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1 Employers Compliance with the Health Insurance Act ANNUAL REPORT Bermuda ea Health Council

2 Employers Compliance with the Health Insurance Act Annual Report Contact us: If you would like any further information about the Bermuda Health Council, or if you would like to bring a healthcare matter to our attention, we look forward to hearing from you. Mailing Address: PO Box HM 3381 Hamilton HM PX Bermuda Street Address: Sterling House, 3rd Floor 16 Wesley Street Hamilton HM11 Bermuda Phone: Fax: healthcouncil@bhec.bm Published by: Bermuda Health Council (August 2017) Copyright 2016 Bermuda Health Council Reference as: Bermuda Health Council (2017) Employers Compliance with the Health Insurance Act 1970 Annual Report 2016 Bermuda Health Council: Bermuda. Printed by: Bermuda Health Council

3 EMPLOYERS COMPLIANCE 2016 ANNUAL REPORT For the period 1st January 2016 to 31st December 2016

4 AUTHORITY: Per Section 20 of the Health Insurance Act, the Bermuda Health Council monitors the extent to which employers are compliant with obtaining health insurance coverage for employees. SUMMARY: 1,962 employees regained health insurance coverage in employers were investigated representing 2,581 employees Less employees were without health insurance coverage in 2016 as compared with inspections were conducted during the reporting period 24 non-compliant employers were published on the Council s website A minimum of $663, was recovered in Standard Health Benefit (SHB) Premium on behalf of employees No legal action was pursued in criminal court during 2016 METHODOLOGY: 1. The Health Council monitors employers compliance with the Health Insurance Act 1970 by investigating queries from the public regarding businesses with inactive health insurance policies and requiring reporting from local insurers about employers with: Inactive policies (with claims not being paid) Terminated policies New policies 2. Data was provided from the public and private insurers for 1 st January st December Monthly data was also submitted by Bermuda Hospitals Board for employed persons who require medical attention and who do not have health insurance coverage. 3. The Health Council investigates all reports and conducts on-site inspections of employer financial and employment records. For persistent non-compliance, the Health Council facilitates legal action in the criminal courts. Figure 1 illustrates the investigative process.

5 Figure 1 Investigative process Information received Insurers, Public Employer Inquiry phone calls, mailed letters Re- Confirmation of policy status Insurer Publishing of Non-compliant employer to website Inspection Legal Action RESULTS: 4. Per Table 1 below, the reported number of non-complaint employers steadily declined throughout However, the ratio of uninsured employees to non-compliant employers increased. In January 2016, there were 88 employers reported without health insurance coverage for 345 employees; in December 2016 there were 46 employers without health insurance coverage for 352 employees representing a 52% decrease and 2% increase, respectively, from the beginning of the year. Table 1 - Summary of Reported Health Insurance Policies 2016 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Inactive Policies Insureds Affected Reported Post Followup Reported Post Followup Of the employers investigated during the year for having inactive health insurance policies, 393 (67%) settled their arrears and re-established their policies. This resulted in 1,962 (70%) employees regaining health insurance coverage, as per Figure As a result, a minimum of $663, was recovered in SHB premium. This figure is based on an uninsured employee s monthly SHB coverage: 1,962 employees x $ = $663, (The Standard Premium Rate (SPR) remained the same from January December 2016.) The total amount of premium recovered, including supplemental benefits, exceeds $663,

6 Figure 2. Policy Status/Number of Insureds (Pre/Post Follow-up) 7. Web publication of non-complaint employers on the Health Council s website was implemented on 3 rd June Throughout the 2016 reporting period, 24 employers were named on the website, with 21% (5) becoming compliant. CONCLUSION: 8. Overall, the number of non-compliant employers continues to decline. This can be attributed to increased awareness of the legislation by our publishing of the names of non-compliant employers on the website and increased communication, online and in print. The public and affected employees continue to report inactive health insurance coverage and generally, employers are responsive to the Health Council s investigations. 9. The Health Council has received feedback from employees that there are a number of employers who have never obtained a health insurance policy for employees. In the upcoming months we anticipate targeted inspections in specific industry areas to address these concerns. We invite employers to contact local insurers to obtain a policy. 3